Just over 10% of middle and high school students have smoked from a hookah, most commonly in someone’s home, a new study found.
Researchers from the Centers for Disease Control and Prevention (CDC) said the social nature of smoking from a hookah water pipe, its diverse flavors and the lack of resemblance to cigarettes may entice young users who may not be aware of its dangers.
The team set out to explore trends in hookah smoking by analyzing data from the 2016 National Youth Tobacco Survey of nearly 21,000 sixth- to 12th-graders. They reported results in “Social Aspects of Hookah Smoking Among U.S. Youth” (Agaku I, et al. Pediatrics. July 2, 2018, http://pediatrics.aappublications.org/content/early/2018/06/28/peds.2018-0341).
Among the 10.5% who had ever smoked from a hookah, 66% were former smokers, 26% were current occasional users and 8% were current frequent users. Females were less likely to be frequent hookah smokers compared to males but more likely to be occasional users. Hispanic and black students were more likely to smoke from a hookah than white students. Speaking a second language also increased the odds of hookah smoking.
More than half of students overestimated how many of their peers were hookah smoking, and students who miscalculated were more likely to smoke occasionally.
The most common places students reported hookah smoking were at a friend’s house, their own house and at a family member’s house, suggesting some parents allow it. Authors said this could make it tougher to enforce laws meant to curb youth smoking.
“These findings buttress the importance of the home as a critical environment for tailoring the content, messaging, and placement of hookah-related health communication interventions for adolescents as well as parents and/or caregivers,” they wrote.
Hookah devices often are used in groups, which may create social pressure to join in, make them more affordable for youths and give users a false sense of safety, according to the study. However, in a single session, users can inhale as much smoke as they would from 100-200 cigarettes, putting them at risk for cancer and heart and lung disease.
Researchers called on pediatricians to educate youths and parents about the dangers of hookah smoking and to consider laws that could curb their use.
“Including hookah prohibitions within the context of comprehensive smoke-free policies, restricting the sale of flavors attractive to youth, and raising the minimum age of buying tobacco products or accessing tobacco establishments (e.g., hookah bars) to 21 could benefit public health,” they wrote.
